Wynkoop, Linda NEW YORK STATE DEPARTMENT OF HEALTH Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Linda Jean Wynkoop Female
Date of Death Age If Veteran of U.S. Armed Forces,
5/25/2018 75 War or Dates
10.2 Place of Death Hospital, Institution or
Z City, Town or Village Queensbury Street Address 25 Arbutus Drive
111
0 Manner of Death n Natural Cause 1-7Accident L Homicide n Suicide l i Undetermined n Pending
ILI Circumstances Investigation
9 Medical Certifier Name Title
Dr Beaty,MD
Address
Glens Falls,NY
Death Certificate Filed District Number tgler Number
City, Town or Village Queensbury,NY 5657
®Burial Date Cemetery or Crematory
May 30,2018 Pine View Cemetery
❑Entombment Address
❑Cremation Quaker Road,Queensbury,NY 12804
Date Place Removed
ZZ F Removal and/or Held
and/or Address
F' Hold
0 Date Point of
u) C Transportation Shipment
p by Common Destination
Carrier
Disinterment Date Cemetery Address
Reinterment Date Cemetery Address
Permit Issued to Registration Number
} Name of Funeral Home Singleton Sullivan Potter Funeral Home 01596
Z Address
407 Bay Road,Queensbury,NY 12804
Name of Funeral Firm Making Disposition or to Whom
1- Remains are Shipped, If Other than Above
tee; Address
tt
tt1
1 Permission is hereby ranted to dispose of the human re ains describe a ove as indicated.
Date Issued S 1����-a l egistrar of Vital Statistics _ �C'� a ..,
._ (signature)
District Numb&CSfl Place \ 1 , a c .esu-6,1
I certify that the remains of the decedent identified above were disposed of in accorIS with this permit on:
i—
W Date of Disposition 5/3 0/2 0 1 8 Place of Disposition Pine View Cemetery Queensbury
2 (address)
Wco Uncas #3299 2
CL (section) (lot number) (grave number)
a Name of Sex or Person in Charge of Premises Connie Goeder1-
Z (please print)
//
W Signature h- -�pr- Title Cemetery Superintendent
(over)
DOH-1555(02/2004)